Biomedical subjects

G Mattioli

Publications and source records attributed to G Mattioli.

At least 199 records · Page 11Linked to original sources

PubMedDate not supplied

Restoration of atrial function after atrial fibrillation of different etiological origins.

In order to evaluate atrial function after the restoration of normal sinus rhythm in patients with atrial fibrillation, an echocardiographic study was performed in 60 patients hospitalized for atrial fibrillation that was subsequently converted to sinus rhythm. The study population consisted of 60 patients, 41 males and 19 females, with a mean age of 67 +/- 8 years. In etiological terms, 20 patients had atrial fibrillation with no associated pathology, 20 had an underlying ischemic cardiopathy and 20 had hypertension. The duration of atrial fibrillation varied from 24 h to 6 months. The restoration of sinus rhythm was spontaneous in 20 patients and drug induced in 40. Patients were divided into groups on the basis of the duration of the atrial fibrillation, the etiology of the atrial fibrillation and the size of the atrium. Transmitral Doppler inflow patterns at rest were assessed within 24 h after conversion to sinus rhythm, and 1 week, 1 month and 3 months later. The statistical significance of serial changes in peak A velocity and A wave integral was determined by analysis of variance. Using the peak A wave for atrial filling and the velocity-time integral as the index of atrial mechanical function, the following results were obtained: restoration of atrial mechanical function occurred earlier in hypertensive patients and in patients with atrial fibrillation only than in patients with associated ischemic cardiopathy. Restoration also occurred earlier in the group of patients that had atrial fibrillation for < 24 h and in patients whose left atrium was of normal size. Since the mechanical activity of the left atrium, evaluated as the peak A wave, does not necessarily return immediately after the restoration of sinus rhythm, a follow-up assessment of the contraction of the left atrium is appropriate.

Aged↗

PubMedDate not supplied

Stroke in paced patients with sick sinus syndrome: relevance of atrial mechanical function, pacing mode and clinical characteristics.

Patients with sick sinus syndrome have a high prevalence of cerebral ischemia and emboli of the viscera and extremities. The present study was designed to establish the prevalence of stroke in patients with sick sinus syndrome, with specific attention to pacing mode, atrial function (evaluated using Doppler echocardiography) and the clinical condition of the patients. The prospective study analyzed 80 consecutive patients with sick sinus syndrome who received either atrial, dual chamber or ventricular pacemakers. Patients underwent a cranial CT scan at the time of enrollment and again at the end of the study 24 months later. End points of the study were cerebral ischemia or emboli of the viscera or extremities. Clinical and echocardiographic features were assessed at the beginning of the study. A multivariate regression analysis was applied to all variables that had at least a marginal univariate predictive value. Cerebral ischemia occurred in 13 patients and emboli of the viscera or extremities were observed in 2 patients. Univariate predictors for embolism consisted of a prior history of cerebrovascular disease (p < 0.001), low atrial ejection force (p < 0.01) and a dilated left atrium with spontaneous echo contrast (p < 0.05). Independent risk factors for stroke included a history of previous cerebral ischemia, age > 65 years, left atrial echo contrast on an echocardiogram and a depressed atrial ejection force. These findings identified patients at high risk for the development of peripheral embolism among the group of patients paced for sick sinus syndrome.

Adolescent↗

PubMedDate not supplied

[Study of the retroperitoneal lymphatic spread of müllerian ovarian carcinoma, using lymphography].

From January 1973 to May 1974, 117 patients with ovarian carcinomas were evaluated with lymphography. The tumors were staged and classified histopathologically according to FIGO (1971). Considering all cases, lymphography showed nodal metastases in 44 patients (38%). Lymphography was positive in 36% of serous cystoadenocarcinomas, in 26% of mucinous cystoadenocarcinomas, in 15% of endometrioid carcinomas and in 36% of unclassified carcinomas. Of the 10 cases not identified by cell type, lymphography was positive in 40% of cases. In 68% of cases bilateral involvement was found. The site of metastatic nodes was in 32% of cases only in the iliac chains were both involved. Considering the single node chains we found 36% of para-aortic, 27% of common iliac, 35% of external iliac and 2% of inguinal involvement. Metastases were observed, regardless of histological type, in 25% of cases in stage III, 62% iin stage IV, 54% in recurrences and only in 5% of cases in stage I. Therefore the lymphatic spread seems to occur in more advanced stages and in recurrences. In 28 of 117 patients node biopsy was performed. Histological-lymphographic correlation was correct in 7/7 positive cases and in 19/21 negative cases (93%). These results show that lymphography is a reliable tool in the evaluation of ovarian cancer.

Adenocarcinoma↗

PubMedDate not supplied

[Nephroblastoma presenting with massive hematuria may require emergency surgery].

About 20% of children with nephroblastoma at onset present with macroscopic haematuria, which is usually asymptomatic and of little clinical relevance. The Authors describe an unusual case of nephroblastoma presenting with massive haematuria causing extensive blood clothing along the urinary tract and bladder. The phenomenon was of such entity to determine urinary retention and induce performing emergency nephrectomy. Tumour resection was radical and postoperative course uneventful. Eighteen months after surgery patient is in excellent status and full remission.

Emergencies↗

PubMedDate not supplied

[Berylliosis in Italy: a case of "sarcoidosis" under the threshold limit value].

BACKGROUND: Berylliosis is caused by a chronic immune reaction to beryllium; in Italy the first case of beryllium exposure-related disease was described in 1935 by Fabroni-Marradi and two additional cases of beryllium disease were subsequently described by Ambrosi and co-workers in 1968. No case has since been recognized using the standardized criteria including immunological testing. OBJECTIVES: To describe a case report of clinically significant berylliosis that occurred in a man exposed to beryllium for ten years in the workplace at concentrations below the permitted threshold limit value. METHODS: The man complained of dyspnoea, dry cough, weakness and weight loss for the past year and was at first diagnosed as suffering from sarcoidosis because of increased angiotensin converting enzyme levels, alteration of hepatic and renal functional indexes, the presence of diffused reticulo-nodular lung abnormalities with high resolution computed tomography that also showed enlarged mediastinal lymph nodes, abnormal lung physiology with reduced diffusion capacity and a bronchial biopsy showing granulomatous lesions. Because of the occupational history immunological testing and high resolution HLA class II typing were performed. RESULTS: The high response to beryllium in the lymphocytes proliferation test and the HLA typing which revealed the presence of the two susceptibility markers HLA-DPGlu69 and HLA-DRPhe47 led to a diagnosis of berylliosis. CONCLUSIONS: The importance is stressed of suspecting a diagnosis of berylliosis in the proper occupational contexts and encouraging the use of immunological tests for diagnosis, and also the need for critical revision of the permitted threshold limit values.

Adult↗

PubMedDate not supplied